CMS NEWS: Medicare will now cover lung cancer screening with Low Dose Computed Tomography (LDCT)

CMS NEWS: Medicare will now cover lung cancer screening with Low Dose Computed Tomography (LDCT)

National Coverage Determination (NCD) for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT)Today the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination that provides for Medicare coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT). The coverage is effective immediately. “This is the first time…

Florida Medicaid requires Prior Authorization for B12 Injections

Florida Medicaid requires Prior Authorization for B12 Injections

Cyanocobalamin (Vitamin B-12 injections, J3420) is reimbursed by Medicaid at the point of sale (without prior authorization) for dialysis patients only. However, if the patient has a diagnosis of pernicious anemia a prior authorization request may be submitted for review. REVIEW CRITERIA: (All of the following must be met) 1. Confirmed diagnosis of Pernicious Anemia 2….

Florida Medicaid Reimbursement for Inpatient Hospital Services

Florida Medicaid Reimbursement for Inpatient Hospital Services

Looking for information about Medicaid hospital reimbursement? Medicaid reimburses licensed, Medicaid-participating hospitals for inpatient services. The services must be provided under the direction of a licensed physician or dentist. Medicaid hospital reimbursement for inpatient hospital services include room and board, medical supplies, diagnostic and therapeutic services, use of hospital facilities, drugs and biologicals, nursing care,…

Medicaid Providers will receive reimbursements at Medicare Levels

Medicaid Providers will receive reimbursements at Medicare Levels

Health and Human Services (HHS) Secretary Kathleen Sebelius announced the final rule on November 01, 2012 implementing the part of the health care law that delivers higher payments to primary care physicians serving Medicaid beneficiaries.  The new rule raises rates to ensure doctors are paid the same for treating Medicare and Medicaid patients and does…

Florida Medicaid will reimburse only 2 Office visits (99201-99215) per month

Florida Medicaid will reimburse only 2 Office visits (99201-99215) per month

Beginning August 1, 2012, reimbursement for procedure codes CPT 99201 – CPT 99215 is limited to two per month for general services.  This affects the following provider types and specialties: provider types 25, 26, 29 and 30 with a specialty code of 009 (Family Practice), 011 (General Practice), 012 (Preventive Medicine), 018 (Internal Medicine), 045…

Will Medicaid pay for CPT codes G0179, G0180, G0181, G0182, 99374, 99375, 99377, 99378, 99379 and 99380

Will Medicaid pay for CPT codes G0179, G0180, G0181, G0182, 99374, 99375, 99377, 99378, 99379 and 99380

Medicaid will not reimburse an attending physician for certifying the home health plan of care. This is considered as already reimbursed to the attending physician through any evaluation and management services provided throughout the period of illness that the recipient is receiving home health care assistance. CPT G0179 CPT G0180 CPT G0181 CPT G0182 CPT…